Provider Demographics
NPI:1932554003
Name:EWING, ERIC MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MICHAEL
Last Name:EWING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E 149TH STREET
Mailing Address - Street 2:9TH FLOOR D WIN RM 216
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-579-4883
Mailing Address - Fax:718-579-4860
Practice Address - Street 1:234 E 149TH STREET
Practice Address - Street 2:9TH FLOOR D WIN RM 216
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-579-4883
Practice Address - Fax:718-579-4860
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2018-03-15
Deactivation Date:2016-12-14
Deactivation Code:
Reactivation Date:2018-03-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program